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Fluid and electro
Fluid and electrolytes
| Question | Answer |
|---|---|
| The two largest constituents of the body fluids | water and electrolytes |
| function of water | vehicle for the transportation of substances to and from the cells, to aid heat regulation by providing perspiration, to assist maintenance of hydrogen balance in the body and to serve as a medium for the enzymatic ation of digestion |
| water varies by | age, sex and health status |
| sodium | 135-145mEq/L major cation of the extracellular fluid major rold in regulation of water baolance Regulates extracellular fluid bolume through osmotic pressure |
| potassium | 3.5-5.0 mEq/L |
| Calcium | 8.4-10.6 mg/dL |
| Magnesium | 1.3-2.5 mg/dL |
| Phosphate | 2.5-4.5 mg/dL |
| Chloride | 96-106 mEq/L |
| Bicarbonate | 22-26mq/L |
| Extracellular fluid | transports water, nutrients, oxygen, waste to and from cells high in sodium contentintravascular, interstitial, Transcellular |
| intravascular fluid | fluid within the blood vessels. consists of plasma and fluid within blood cells. contains large amounts of protein and exectrolytes |
| interstitial fluid | fluid in the spaces surrounding the cells. High in sodium content |
| Transcellular fluid | includes aqueous humor; slava; cerebrospinal, pleural, peritoneal, synovial, and pericardial fuids; gastrointestinal secretions, and cluid in urinary system and lymphatics |
| intracellular fluid | fluid contained within the cell walls high in potassium content |
| essential to the transmission of nerve impulses and helps maintain neuromuscular irritability important in controlling contractility of the heart helpls to maintain acid-base balance Aids in maintenance of electroneutrality | Sodium |
| major intracellular cation important to nerve transmission and muscle contration helps maintain normal heart rhythm helps maintain plasma acid-base balance | Potassium |
| involved in formation of bone and teeth necessary for blood coagulation essential for normal nerve and muscle activity | Calcium |
| Necessary for buildign bones and teeth necessary for nerve treansmission and is involved in muscle contration plays an important role in many metabolic reations, where it acts as a cofactor to cellular enzymes | magnesium |
| necessary for formation of adenosine triphosphate cofactor in carbohydrate, protein, and lipid metabolism activates B-compolex vitamins | phosphate |
| helps maintain acid-base balance. Important to formation of hydrochloric acid for secretion to the stomach. Aids in maintaining plasma electroneutrality. | chloride |
| a buffer that neutralizes excess acids in the body. helps to regulate acid-base balance. | bicarbonate. |
| hypovolemia | decreased volume of polasma |
| hypothalamus | contains the thirst mechanism that helps control fluid balance in the body. |
| insensible | invisible |
| Kidney | main organ through which fluid excretion is achieved. |
| hormones that affect urine output | antidiuretic hormone, aldosterone, and atrial natriuretic peptide. |
| ADH | secreted by the posterior pituitary more is released when the blood becomes more concentrated or there is decreased circulating blood volume, and during times of pain nausea and stress. |
| when ADH is secreted | renal tubules reabsorb more water and urine output decreases |
| Aldosterone | relased by the adrenal cortex when ECF volume is low or when sodium concentration is elevated casueing reabsorption of sodium from kidney tubules. |
| Renin-angiotensin-aldosterone | stimulates the relese of aldosterone. |
| atrial natriuretic peptide ANP | protects to body from fluid overload and is released from sites in the myocardium and the brain. |
| Passive transport | Diffusion, ossmosis, filtration |
| Diffusion | the process by which substances move back and forth across the membrain until they are evenly distributed throughout the available space. |
| Concentration gradient | substances will move from a high to a low concentration until the concentration on both sides of the membrane is equal. |
| moves by diffusion(process of equalization) | Glucose, oxygen, carbondioxide, water, and other small ions and molecules. |
| Electrical gradiant | a type of diffusion The attration between particles of opposit charge and the repellent action between particles of lark charge. |
| Osmosis | the movement of pure solvent across a membrane.eg water |
| semipermeable membrane | a membrane that allows some substances to pass through but prevents the passage of other substances. |
| solvent | liquid |
| solute | solid |
| isotonic | of equal solute |
| hypertonic | of greater concentration |
| hypotonic | of less concentration |
| filtration | the movement of water and suspended substances outward through a semipermeable membrane |
| hydrostatic pressure | pressure exerted by fluid causes fluid ot press outward on vessel this force promotes filtration forsing movement of water and electrolytes through the caplillary wall to the interstitial fluid. eg heart |
| active transport | requires cellular energy. usues adenosine triphosphate |
| any disease that affects circulation | will ultimately affect the distribution and composition of body fluids; chf |
| those at risk for deficient fluid volume | patients unable to take in sufficient quantities of fluid because of impared swallowing extreme weakness, disorientation or coma, or the unabailabilityy of water, patients whos lose excessive amounts of fluid through prolonged vomiting, diarrhea, hemorrha |
| treatments that can cause a fluid deficit | diuretic therapy and gastrointestinal suction with out fluid replacement. |
| dehydration | loss of water from the cells. |
| burns and ddranage from large wounds or fistulas | can deplete fluid volume |
| fistula | an abnormal connection between an organ, vessel, or intestine and another organ, vessel or intestine, or the skin. Fistulas can be thought of as tubes connecting internal tubular structures, such as arteries, veins, or intestine, to one anoth |
| signs of over hydration | weighgain, crackles in the lungs, slow bounding pulse, elevated blood pressure, and possibley edema |
| hypervolumia | excessive blood volume |
| Edema | excessive accumulation of interstitial fluid |
| dependant edema | (blank) |
| generalized edema | excess intestitial fluid is spread throughout the body. |
| generalized edema cause | kidney failure, heart failure, liver failure and hormonal disorders overproduction of aldosterone and adh. |
| local edema cause | infection or injury |
| hyponatremia | a deficit of sodium in the blood can occur from sodium loss or excess water. excessive vomiting or diarrhea, decreased secretion of aldosterone |
| ascites | abnormal accumulation of fluid within the peritoneal cavity |
| excessive water retention and lower sodium | congestive heart failure, liver disease, chronic renal failure |
| more water | results in hypervolemia and hyponatremia |
| hypernatremia | sodium concentration rises above 145 excess of sodium or loss of body water |
| acidosis | excess of acid or depletion of alkaline substances in the blood and body tissues |
| casues of hypernatremia | water loss from fever, respirator infection, or watery diarrhea. decreased water intake damage to the hypothalamus. |
| damage to the hypothalamus | can result in hypernatremia. |
| hypernatremai causes these changes in the cells | osmotic shift of fluid from the cells to the interstitial spaces causing cellular dehydration and interruption of nurmal cell process |
| hypokalemia | when potassium level falls below 3.5 may occur due to poor diet, illness causeing a shift of potassium from ECF to ICF vomitting diarrhea, gastrointestinal suction, excessive sweating, and diuretic therapy. cardiac arrest or arrhythmia |
| hyperkalemia | when potassium levels rice above 5.0. can cause arrhythmia |
| risk for hyperkalemia | pt with severe burns, crush injuries, undergoing major surgers renal failure, overuse of potassium sparing diuretics, digitalis toxicity, overuse of potassium-containing salt substitutes, uncontrolled diabetes mellitus. |
| hypercalcemia | calcium level drops below 8.4 |
| causes of hypercalcemia | metastatic cancer invading bone, removing parathyroid gland, excessive infusion of bicarbonate solution, blood transfusion |
| alkalosis | excess of alkaline or decrease of acid substances in the blood and body fluids |
| hypercalcemia | serum calcium level above 10.6 |
| hypercalcemia is found when | hyperparathyroidism or malignacy myeloma and lung or renal cancers. |
| hypomagnesemia | serum level below 1.3 results from malabsorption or increased loss from renal tubular dysfunction or thiazide diuretic use, gastric suction or diarrhea. |
| hypomagnesema usually accompanies | hypocalcemia |
| hypermagnesemia | a serum level above 2.1 renal failure |
| hypercloremia | lvele below 96 associated with hyponatremia sever vomiting |
| hypercloremia | level above 106 occurs with hypernatremia and a form of metabolic acidosis |
| hypohposphatemia | level of phosphate below 3.0 aluminum containing antacids or hperparatyroidism |
| hyperphosphatemia | level aboce 4.5 renal failure. |
| ph | 7.35-7.45 normal serum range |
| respiratory acidosis | slow, shallow respirations, respiratory congestion/obstrucion ph<7.35 |
| metabolic acidosis | shock poor circulatin diabetic ketoacidosis renal failure diarrhea ph<7.35 |
| respitory alkalosis | hyperventilation ph>7.45 |
| metabolic alkalosis | vomiting, excessive antacid intaks hypokalemiph>7.45a |
| alkalosis | adecrease in hydrogen ions increase in ph |
| acidosis | an increase in hydrogen ions decrease in ph |
| ph controling mechanisms | blood buffer system, lungs, urinary system |
| effects of alkalosis | irritability of nervous systemreslessness, muscle twitching and tingling |
| mental confusion, altered level of consciousness, anxiety, coma, anorexia, nausea, vomiting, muscle cramp, seizures, decreased sensation | hyponatremia |
| dry mucous membranes, loss of skin turgor intense thirst, flushed skin, oliguria, weakness, lethargy irritability, twitching, seeizures, coma, intracranial bleeding | hypernatremia |
| abdominal pain, gaseous distention of intestines, cardiac dysrhythmias, muscle wekness decreased reflexes, paralysis, paralytic ileus, urinary retention, lethargy, confusion, electrocardiogram changes, increased urinary ph | hypokalemia |
| muscle weakness, hypotension, parestesias, paralysis, cardia dysrhythmias ecg changes | hyperkalemia |
| List the four main functions of water in the body | The main functions of water in the body are: (1) as a vehicle for the transportation of substances to and from the cells; (2) to aid heat regulation by providing perspiration, which evaporates; (3) to assist maintenance of hydrogen (H+) balance in the bod |
| Who is affected more quickly and more seriously by minor changes in fluid balance? | Infants and the elderly are more quickly affected by minor changes in fluid balance and can become rapidly dehydrated. |
| Name the three types of extracellular fluid. | Intravascular, interstitial, and transcellular |
| Describe how hyertonic, hypotonic, and isotonic solutions differ | Isotonic solution is when the water concentration of the intracellular and extracellular fluids is equal. The solution is hypertonic if the cells are surrounded by a solution that has a greater concentration of solute than the cells. A hypotonic solution |
| Who is at risk for deficient fluid volume? | (1) patients unable to take in sufficient quantities of fluid because of impaired swallowing, extreme weakness, disorientation or coma, or the unavailability of water; and (2) patients who lose excessive amounts of fluid through prolonged vomiting, diarrh |
| List the signs and symptoms of dehydration | Thirst; weakness; complaints of dizziness; postural hypotension; decreased urine production,; dark, concentrated urine; dry, cracked lips and tongue; dry mucous membranes; thick saliva; dry, scaly skin; poor skin turgor; flat neck veins when lying down; i |
| What are the causes of generalized edema? | Kidney failure, heart failure, liver failure, and hormonal disorders involving the overproduction of aldosterone and ADH. |
| What are the three control mechanisms for pH? | (1) Blood buffer system; (2) lungs, (3) urinary system |
| List the nursing diagnoses commonly used for patients who have fluid, electrolyte, or acid-base imbalances. | Deficient fluid volume, excess fluid volume, risk for imbalanced fluid volume, ineffective tissue perfusion, decreased cardiac output, impaired gas exchange, ineffective breathing pattern. |
| What must be done for patients who will be unable to take in fluids or food on their own for an extended period? | A feeding tube must be placed or total parenteral nutrition is started. |
| The main body electrolytes | sodium (Na+), potassium (K+), calcium, (Ca2+), and magnesium (Mg2+) |
| other body electrolytes | bicarbonate ions, phosphate, sulfate, and organic acid ions. |
| The ECF contains the largest quantities of | sodium, chloride, and bicarbonate ions. |
| The ICF contains large quantities of | potassium and phosphate ions and moderate quantitites of magnesium and sulfate ions. |
| Colloid osmotic pressure | movement of fluid between the intravascular and interstitial compartments, based on the number of solute particles on the concentrated side and the presence of a semi-permeable membrane. |
| the body’s weight is made up of water | 45% to 75% |
Created by:
Slaw108